HCPCS J9071 (Cyclophosphamide) Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Chemotherapy Drugs |
| Common Place of Service | • 11 - Office • None |
| Complexity Level | Low |
| Medicare Payment Limit | $0.63  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 55150-0270-99 - CYCLOPHOSPHAMIDE (MDV,PF,LATEX-FREE) 200 MG/1 ML • 55150-0271-99 - CYCLOPHOSPHAMIDE (MDV,PF,LATEX-FREE) 200 MG/1 ML • 55150-0272-01 - CYCLOPHOSPHAMIDE (MDV,PF,LATEX-FREE) 200 MG/1 ML |
National average reimbursement for HCPCS J9071 by major payers:
$1.32
$1.26
$1.68
$1.25
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS J9071 | ||||||
United | J9071 | $4.38 | 1679523625 - CHRISTOPHER JORDAN | 846002707 - (CO) MONTROSE MEMORIAL HOSPITAL | TX | Medical Oncology Physician (207RX0202X) |
United | J9071 | $4.38 | 1720510100 - ANMOL SINGH | 541795091 - (VA) VIRGINIA CANCER SPECIALISTS, P.C. | TX | Hematology & Oncology Physician (207RH0003X) |
United | J9071 | $0.95 | 1578714424 - PHILIP KOVOOR | 752131429 - US ONCOLOGY CORPORATE, INC. | TX | Medical Oncology Physician (207RX0202X) |
United | J9071 | $0.95 | 1588906457 - GARY LU | 752131429 - US ONCOLOGY CORPORATE, INC. | TX | Hematology & Oncology Physician (207RH0003X) |
United | J9071 | $0.74 | 1326011347 - MOHAMED HAQ | 742104565 - MOHAMED M. HAQ, M.D. | TX | Hematology & Oncology Physician (207RH0003X) |
United | J9071 | $1.15 | 1184902512 - FARHAN MOHAMMAD | 751312419 - (TX) CANCER CENTER ASSOCIATES | TX | Hematology & Oncology Physician (207RH0003X) |
United | J9071 | $0.77 | 1548284722 - GLADYS RODRIGUEZ | 742915297 - (TX) SOUTH TEXAS ONCOLOGY & HEMATOLOGY, PLLC | TX | Hematology & Oncology Physician (207RH0003X) |
United | J9071 | $0.95 | 1386688232 - CELESTE WILCOX | 752131429 - US ONCOLOGY CORPORATE, INC. | TX | Medical Oncology Physician (207RX0202X) |
United | J9071 | $0.91 | 1285707091 - LASZLO OSVATH | 132655001 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION | NY | General Acute Care Hospital (282N00000X) |
United | J9071 | $1.59 | 1376864017 - NANNA SULAI | 752131429 - US ONCOLOGY CORPORATE, INC. | TX | Hematology & Oncology Physician (207RH0003X) |
United | J9071 | $0.95 | 1992908347 - KRISHNA ALLURI | 752131429 - US ONCOLOGY CORPORATE, INC. | TX | Hematology & Oncology Physician (207RH0003X) |
United | J9071 | $1.16 | 1629076468 - CHRISTUS HEALTH SOUTHWESTERN LOUISIANA, CHRISTUS OCHSNER ST PATRICK HOSPITAL | 720411322 - (LA) CHRISTUS HEALTH SOUTHWESTERN LOUISIANA | LA | General Acute Care Hospital (282N00000X) |
United | J9071 | $0.69 | 1467458356 - SYED MAZHER | 756002868 | TX | Hematology & Oncology Physician (207RH0003X) |
United | J9071 | $1.28 | 1790734085 - TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER LUBBOCK, TTUHSC/ ONCOLOGY | 752668014 | TX | Medical Oncology Physician (207RX0202X) |
United | J9071 | $1.34 | 1255370201 - MARYADA REDDY | 752536818 - HEALTHTEXAS PROVIDER NETWORK | TX | Medical Oncology Physician (207RX0202X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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HCPCS J9071 vs. Other Chemotherapy Drugs Codes
The HCPCS J9071 code is part of the Chemotherapy Drugs services . It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The HCPCS J9071 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 55150-0270-99-NDC | Moderate | CYCLOPHOSPHAMIDE (MDV,PF,LATEX-FREE) 200 MG/1 ML |
| J9070-HCPCS | Low | Cyclophosphamide, 100 mg |
| J9071-HCPCS | Low | Injection, cyclophosphamide, (auromedics), 5 mg |
| J9098-HCPCS | Moderate | Injection, cytarabine liposome, 10 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J9071. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J9071 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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